Provider Demographics
NPI:1043909252
Name:ORTEGA, LIGAYA SANTOS
Entity Type:Individual
Prefix:
First Name:LIGAYA
Middle Name:SANTOS
Last Name:ORTEGA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7760 FOPPIANO WAY
Mailing Address - Street 2:
Mailing Address - City:WINDSOR
Mailing Address - State:CA
Mailing Address - Zip Code:95492-6899
Mailing Address - Country:US
Mailing Address - Phone:707-837-5133
Mailing Address - Fax:707-620-0268
Practice Address - Street 1:7760 FOPPIANO WAY
Practice Address - Street 2:
Practice Address - City:WINDSOR
Practice Address - State:CA
Practice Address - Zip Code:95492-6899
Practice Address - Country:US
Practice Address - Phone:707-837-5133
Practice Address - Fax:707-620-0268
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA496803695310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility